Type 1 diabetes testing

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Type 1 Diabetes: What Is It?

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What Is Diabetes?

Diabetes is a disease that affects how the body uses glucose, the main type of sugar in the blood.

What Happens in Diabetes?

Our bodies break down the foods we eat into glucose and other nutrients we need, which are then absorbed into the bloodstream from the gastrointestinal tract. The glucose level in the blood rises after a meal and triggers the pancreas to make the hormone insulin and release it into the bloodstream. But in people with diabetes, the body either can’t make or can’t respond to insulin properly.

Insulin works like a key that opens the doors to cells and lets the glucose in. Without insulin, glucose can’t get into the cells (the doors are “locked” and there is no key) and so it stays in the bloodstream. As a result, the level of sugar in the blood remains higher than normal. High blood sugar levels are a problem because they can cause a number of health problems.

What Is Type 1 Diabetes?

The two types of diabetes are type 1 and type 2. Both make blood sugar levels higher than normal but they do so in different ways.

In type 1 diabetes, the pancreas loses its ability to make insulin because the body’s immune system attacks and destroys the cells that produce insulin. No one knows exactly why this happens, but scientists think it has something to do with genes. But just getting the genes for diabetes isn’t usually enough. A person probably would then have to be exposed to something else — like a virus — to get type 1 diabetes.

In type 2 diabetes, the pancreas still makes insulin but the body doesn’t respond to it normally. Glucose is less able to enter the cells and do its job of supplying energy (a problem called insulin resistance). This raises the blood sugar level, so the pancreas works hard to make even more insulin. Eventually, this strain can make the pancreas unable to produce enough insulin to keep blood sugar levels normal.

Who Gets Type 1 Diabetes?

Type 1 diabetes can’t be prevented, and there is no real way to predict who will get it. Nothing that either a parent or the child did caused the disease.

Once a person has type 1 diabetes, it does not go away and requires lifelong treatment. Kids and teens with type 1 diabetes depend on daily insulin injections or an insulin pump to control their blood glucose levels.

What Are the Signs & Symptoms of Type 1 Diabetes?

A person can have diabetes without knowing it because the symptoms aren’t always obvious and they can take a long time to develop. Type 1 diabetes may come on gradually or suddenly.

But kids or teens who develop type 1 diabetes may:

  • Need to pee a lot. The kidneys respond to high levels of glucose in the blood by flushing out the extra glucose in urine (pee). Kids with high blood sugar levels need to pee more often and make more pee.
  • Drink a lot of liquids. Because they’re peeing so often and losing so much fluid, they can become very thirsty and drink a lot in an attempt to keep the levels of body water normal.
  • Feel tired often. This is because the body can’t use glucose for energy properly.
  • Lose weight (or not gain weight as they grow). Kids and teens with type 1 diabetes may have an increased appetite, but often lose weight because the body breaks down muscle and stored fat in an attempt to provide fuel to the hungry cells.

In some cases, other symptoms can be the signal that something is wrong. Sometimes the first sign of diabetes is bedwetting in a child who has been dry at night. Diabetes also should be suspected if a girl who hasn’t started puberty yet gets a vaginal yeast infection.

How Is Type 1 Diabetes Diagnosed?

Doctors can say for sure if a person has diabetes by testing blood samples for glucose. When high blood sugars show that a child has diabetes, other blood tests are usually done to help doctors find out if the child has type 1 or type 2 diabetes, because management and treatment of the diabetes may differ based on type.

If diabetes is suspected or confirmed, the doctor may refer your child to a pediatric endocrinologist, a doctor who specializes in the diagnosis and treatment of kids with diseases of the endocrine system, such as diabetes and growth disorders.

How Is Type 1 Diabetes Treated?

Treatment means good diabetes control to minimize symptoms; prevent health problems; and help kids have normal physical, mental, emotional, and social growth and development. To do this, parents and kids should aim to keep blood sugar levels within the goal range as much as possible.

In general, kids with type 1 diabetes need to:

  • take insulin as prescribed
  • eat a healthy, balanced diet with accurate carbohydrate counts
  • check blood sugar levels as prescribed
  • get regular physical activity

Following the treatment plan helps kids stay healthy, but treating diabetes isn’t the same as curing it. Right now, there’s no cure for diabetes, so kids with type 1 diabetes will need treatment for the rest of their lives. But with proper care, they should look and feel healthy and go on to live long, productive lives, just like other kids.

What Problems Can Happen With Type 1 Diabetes?

If early symptoms of diabetes are missed and treatment isn’t started, chemicals called ketones can build up in the blood and cause stomach pain, nausea, vomiting, fruity-smelling breath, breathing problems, and even loss of consciousness. Sometimes these symptoms are mistaken for the flu or appendicitis. Doctors call this serious condition diabetic ketoacidosis, or DKA.

Diabetes also can cause long-term complications in some people, including heart disease, stroke, vision impairment, and kidney damage. It also can cause other problems throughout the body in the blood vessels, nerves, and gums. While these problems don’t usually show up in kids or teens who’ve had type 1 diabetes for only a few years, they can affect them in adulthood, particularly if their diabetes isn’t well controlled.

There’s good news, though — proper treatment can stop or control these diabetes symptoms and reduce the risk of long-term problems.

What’s New in the Treatment of Type 1 Diabetes?

Doctors and researchers are developing new equipment and treatments to help kids cope with the special problems of growing up with diabetes.

Some kids and teens are already using devices that make blood glucose testing and insulin injections easier, less painful, and more effective. One of these is the insulin pump, a mechanical device that can deliver insulin more like the pancreas does. There’s also been progress toward the development of a wearable or implantable “artificial pancreas.” This consists of an insulin pump linked to a device that measures the person’s blood glucose level continuously.

Doctors and scientists are investigating a potential cure for diabetes. This involves transplanting insulin-producing cells into the body of a person with diabetes. Researchers are also testing ways to stop diabetes before it starts. For example, scientists are studying whether diabetes can be prevented in those who may have inherited an increased risk for the disease.

How Can I Help My Child?

Parents can help their kids lead happier, healthier lives by giving constant encouragement, learning what they can about diabetes, and making sure their children eat properly, exercise, and stay on top of blood sugar control every day.

Kids and teens with diabetes need to monitor and control their glucose levels. They need to:

  • check blood sugar levels a few times a day by testing a small blood sample
  • give themselves insulin injections, have an adult give them injections, or use an insulin pump
  • eat a balanced, healthy diet and pay special attention to the amounts of sugars and starches in the food they eat and the timing of their meals
  • get regular exercise to help control blood sugar levels and help avoid some of the long-term health problems that diabetes can cause, like heart disease
  • work closely with their doctor and diabetes health care team to get the best possible diabetes control
  • be watched for signs of complications and other diabetes-related health problems

Living with diabetes is a challenge for anyone, but kids and teens often have special issues to deal with. Young kids might not understand why they need blood tests and medicines. They might be scared, angry, and uncooperative.

Teens may feel different from their peers and want a more carefree lifestyle than their diabetes allows. Even when they faithfully follow their treatment schedule, they might feel frustrated if the natural body changes of puberty make their diabetes somewhat harder to control.

Having a child with diabetes may seem overwhelming at times, but you’re not alone. If you have questions or problems, reach out to the diabetes health care team — they can help with medical issues, and are there to support and help you and your child.

Reviewed by: Shara R. Bialo, MD Date reviewed: August 2018

Type 1 Diabetes Symptoms and Diagnosis

Type 1 diabetes may cause excessive thirst or hunger, slow-healing sores, and other symptoms.

Type 1 diabetes is a chronic disease marked by high blood glucose (sugar) levels, called hyperglycemia.

It’s considered an autoimmune disease, resulting from an immune system attack on the pancreatic beta cells that produce insulin — a hormone that helps certain cells in the body absorb glucose.

And without enough insulin, your blood glucose levels can rise to unhealthy levels, causing a range of health problems.

Type 1 diabetes makes up only about 5 percent of all diabetes cases, according to the Centers for Disease Control and Prevention (CDC).

By comparison, type 2 diabetes — which develops when cells cannot use insulin properly — makes up 90 to 95 percent of all diabetes cases.

However, type 1 and 2 diabetes often share the same symptoms associated with hyperglycemia.

Type 1 Diabetes Symptoms

Possible symptoms of type 1 diabetes include:

  • Excessive thirst or hunger
  • Increased urination
  • Unexplained weight loss
  • Numbness or tingling in the hands or feet, or loss of feeling in the feet
  • Fatigue
  • Dry, itchy skin
  • Vision changes, including blurry eyesight
  • Slow-healing sores and increased rate of infections
  • Nausea, vomiting, and stomach pains (in cases where the disease develops quickly)

Without insulin and the ability to use sugar for energy, the body may start breaking down fat as an alternate source of energy, resulting in high levels of ketones (toxic acids) in the blood.

This condition, called diabetic ketoacidosis, may cause:

  • Dry skin and mouth
  • Inability to keep fluids down
  • Stomach pain
  • Shortness of breath
  • Flushed face
  • “Fruity” smell to breath

Diabetes and Hypoglycemia

People with type 1 diabetes must take insulin — usually by injection, or by using an insulin pump — to provide their cells with the necessary hormone.

However, too much insulin can cause cells to absorb too much glucose from the bloodstream, resulting in low blood glucose, or hypoglycemia.

Symptoms of hypoglycemia include:

  • Headache
  • Unusual hunger
  • Nervousness
  • Body shaking and weakness
  • Rapid heartbeat
  • Increased sweating

Eating or drinking something high in sugar — such as hard candy or fruit juice — can help to quickly treat hypoglycemia.

Type 1 Diabetes Diagnosis

Diagnosis of diabetes — type 1 or type 2 — typically requires one or more blood tests.

A fasting blood glucose test measures your blood glucose level after 8 hours of fasting (no food or drink, except water).

This test is not always reliable, and tends to be more accurate in the morning. Multiple tests conducted at separate times are generally required for a diabetes diagnosis.

If your initial fasting blood glucose test results are normal, but you have some symptoms or risk factors for diabetes, your doctor may conduct an oral glucose tolerance test.

For this test, you will drink a special glucose solution, then take another fasting blood glucose test after two hours have passed.

A random blood glucose test measures your glucose level at an unspecified time. A high blood glucose level, in addition to having one or more symptoms of diabetes, could indicate that you have the disease.

This test is less accurate than a fasting glucose or oral glucose tolerance test.

The glycated hemoglobin test, or A1C test, is a different kind of blood test that provides an overview of your blood glucose levels for the past few months, rather than just a snapshot of your current level.

Unaffected by recent meals, the A1C test measures the percentage of hemoglobin — an oxygen-transporting protein in red blood cells — to which glucose is bound. A high percentage (more than 6.5 percent) indicates diabetes.

After your diagnosis of diabetes, your doctor may also order an autoantibody test, which looks for the antibodies that attack pancreatic beta cells.

The autoantibody test can help differentiate between type 1 and type 2 diabetes.

The Complexity of Diagnosing Type 1 Diabetes

A type 1 diabetes (T1D) diagnosis can happen suddenly and unexpectedly. Many times, the disease is identified through symptoms that can appear as a cold or flu. While it represents a big life change, people with T1D can live long, full, happy lives.

How is T1D diagnosed?

T1D often initially presents itself as the flu or malaise, but physicians must be quick to spot the telltale signs of a possible T1D diagnosis and order additional tests.

Fasting blood-glucose test

Doctors will often recommend a fasting blood-glucose test when they suspect T1D may be present. This is a small sample blood test typically conducted in the morning after fasting overnight. The fasting helps give doctors a clear look at how the body manages blood-sugar levels without the impact of food intake.

Oral glucose tolerance test

The oral glucose test takes the fasting test one step further. After fasting and having an initial blood test, people drink a sugary drink and then have their blood sugar tested over the course of approximately two hours. This shows the benchmark sugar without outside influences and later measures how the body responds to carbohydrate (sugar) intake.

Random blood-glucose test

The quickest option for testing for T1D is a random glucose test. This test simply measures a patient’s current blood sugar regardless of when and what he or she ate most recently. On occasion, this will be the first test, and then doctors will elevate to tests noted above as needed.

Glycated hemoglobin (HbA1c) test

The most comprehensive test is the hemoglobin A1c test. This blood test shows the average blood-sugar level for the past two or three months.

The honeymoon phase

The onset of symptomatic diabetes doesn’t always happen all at once. During what is known as the “honeymoon phase,” people with T1D can experience a period in which they are asymptomatic. The honeymoon phase typically lasts a few months to a year post-diagnosis as, with the help of some injected insulin, a patient’s existing beta cells continue to function normally and produce enough insulin for blood-glucose management. Eventually, the majority of the insulin-producing beta cells in the pancreas cease functioning and the diabetes symptoms return.

The honeymoon phase and treatment

No matter how good A1C or blood-sugar tests are during the honeymoon phase, the disease is still present and killing beta cells. During this phase, physicians will help maintain blood-glucose management with low-dose insulin treatments. Eventually, the remaining healthy cells will die off and insulin dosages will need to be increased.

What it means for people with T1D

T1D is fairly predictable with regard to endocrine system function during the honeymoon phase, but every case varies just a bit. Paying close attention to the body’s responsiveness to insulin therapy paired with regular blood-sugar testing is paramount to successful management.

Less common T1D tests

Because each case can be as unique as the individual, some doctors may employ the following tests to find markers of T1D to ensure the optimal treatment plan:

  • C-Peptide
    While most tests check for antibodies, this test measures how much C-peptide is in a person’s blood. Peptide levels typically mirror insulin levels in the body. Low levels of C-peptide and insulin can point to T1D.
  • Insulin Autoantibodies (IAA)
    This tests looks for the antibodies targeting insulin.
  • Insulinoma-Associated-2 Autoantibodies (IA-2A)
    This test looks for antibodies mounted against a specific enzyme in beta cells. Both the IA-2A and GADA tests are common T1D antibody tests.
  • Zinc Transporter 8 (ZnT8Ab)
    This test looks at antibodies targeting an enzyme that is specific to beta cells.
  • Islet Cell Cytoplasmic Autoantibodies (ICA)
    Islet cells are clusters of cells in the pancreas that produce hormones, including insulin. This test identifies a type of islet cell antibodies present in up to 80 percent of people with T1D.
  • Glutamic Acid Decarboxylase Autoantibodies (GADA or Anti-GAD)
    This test looks for antibodies built against a specific enzyme in the insulin-producing pancreatic beta cells.

How age affects a T1D diagnosis

There are some side effects in the overall health of a person with T1D that present themselves in time. Diabetic eye disease and kidney, nerve or circulation damage can appear in people who have had T1D for 15 years or more. With proper maintenance and routine checkups, these effects can often be limited or avoided altogether.

Type 1 Diabetes

On this page:

  • What is type 1 diabetes?
  • Who is more likely to develop type 1 diabetes?
  • What are the symptoms of type 1 diabetes?
  • What causes type 1 diabetes?
  • How do health care professionals diagnose type 1 diabetes?
  • What medicines do I need to treat my type 1 diabetes?
  • How else can I manage type 1 diabetes?
  • Do I have other treatment options for my type 1 diabetes?
  • What health problems can people with type 1 diabetes develop?
  • Can I lower my chance of developing type 1 diabetes?

What is type 1 diabetes?

Diabetes occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes mainly from the food you eat. Insulin, a hormone made by the pancreas, helps the glucose in your blood get into your cells to be used for energy. Another hormone, glucagon, works with insulin to control blood glucose levels.

In most people with type 1 diabetes, the body’s immune system, which normally fights infection, attacks and destroys the cells in the pancreas that make insulin. As a result, your pancreas stops making insulin. Without insulin, glucose can’t get into your cells and your blood glucose rises above normal. People with type 1 diabetes need to take insulin every day to stay alive.

People with type 1 diabetes need to take insulin every day.

Who is more likely to develop type 1 diabetes?

Type 1 diabetes typically occurs in children and young adults, although it can appear at any age. Having a parent or sibling with the disease may increase your chance of developing type 1 diabetes. In the United States, about 5 percent of people with diabetes have type 1.1

What are the symptoms of type 1 diabetes?

Symptoms of type 1 diabetes are serious and usually happen quickly, over a few days to weeks. Symptoms can include

  • increased thirst and urination
  • increased hunger
  • blurred vision
  • fatigue
  • unexplained weight loss

Sometimes the first symptoms of type 1 diabetes are signs of a life-threatening condition called diabetic ketoacidosis (DKA). Some symptoms of DKA include

  • breath that smells fruity
  • dry or flushed skin
  • nausea or vomiting
  • stomach pain
  • trouble breathing
  • trouble paying attention or feeling confused

DKA is serious and dangerous. If you or your child have symptoms of DKA, contact your health care professional right away, or go to the nearest hospital emergency room.

What causes type 1 diabetes?

Experts think type 1 diabetes is caused by genes and factors in the environment, such as viruses, that might trigger the disease. Researchers are working to pinpoint the causes of type 1 diabetes through studies such as TrialNet.

How do health care professionals diagnose type 1 diabetes?

Health care professionals usually test people for type 1 diabetes if they have clear-cut diabetes symptoms. Health care professionals most often use the random plasma glucose (RPG) test to diagnose type 1 diabetes. This blood test measures your blood glucose level at a single point in time. Sometimes health professionals also use the A1C blood test to find out how long someone has had high blood glucose.

Even though these tests can confirm that you have diabetes, they can’t identify what type you have. Treatment depends on the type of diabetes, so knowing whether you have type 1 or type 2 is important.

To find out if your diabetes is type 1, your health care professional may test your blood for certain autoantibodies. Autoantibodies are antibodies that attack your healthy tissues and cells by mistake. The presence of certain types of autoantibodies is common in type 1 but not in type 2 diabetes.

Because type 1 diabetes can run in families, your health care professional can test your family members for autoantibodies. Type 1 diabetes TrialNet, an international research network, also offers autoantibody testing to family members of people diagnosed with the disease. The presence of autoantibodies, even without diabetes symptoms, means the family member is more likely to develop type 1 diabetes. If you have a brother or sister, child, or parent with type 1 diabetes, you may want to get an autoantibody test. People age 20 or younger who have a cousin, aunt, uncle, niece, nephew, grandparent, or half-sibling with type 1 diabetes also may want to get tested.

What medicines do I need to treat my type 1 diabetes?

If you have type 1 diabetes, you must take insulin because your body no longer makes this hormone. Different types of insulin start to work at different speeds, and the effects of each last a different length of time. You may need to use more than one type. You can take insulin a number of ways. Common options include a needle and syringe, insulin pen, or insulin pump.

Some people who have trouble reaching their blood glucose targets with insulin alone also might need to take another type of diabetes medicine that works with insulin, such as pramlintide. Pramlintide, given by injection, helps keep blood glucose levels from going too high after eating. Few people with type 1 diabetes take pramlintide, however. The NIH has recently funded a large research study to test use of pramlintide along with insulin and glucagon in people with type 1 diabetes. Another diabetes medicine, metformin, may help decrease the amount of insulin you need to take, but more studies are needed to confirm this. Reseachers are also studying other diabetes pills that people with type 1 diabetes might take along with insulin.

Hypoglycemia, or low blood sugar, can occur if you take insulin but don’t match your dose with your food or physical activity. Severe hypoglycemia can be dangerous and needs to be treated right away. Learn more about hypoglycemia and how to prevent or treat it.

How else can I manage type 1 diabetes?

Along with insulin and any other medicines you use, you can manage your diabetes by taking care of yourself each day. Following your diabetes meal plan, being physically active, and checking your blood glucose often are some of the ways you can take care of yourself. Work with your health care team to come up with a diabetes care plan that works for you. If you are planning a pregnancy with diabetes, try to get your blood glucose levels in your target range before you get pregnant.

Do I have other treatment options for my type 1 diabetes?

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has played an important role in developing “artificial pancreas” technology. An artificial pancreas replaces manual blood glucose testing and the use of insulin shots. A single system monitors blood glucose levels around the clock and provides insulin or a combination of insulin and glucagon automatically. The system can also be monitored remotely, for example by parents or medical staff.

In 2016, the U.S. Food and Drug Administration approved a type of artificial pancreas system called a hybrid closed-loop system. This system tests your glucose level every 5 minutes throughout the day and night through a continuous glucose monitor, and automatically gives you the right amount of basal insulin, a long-acting insulin, through a separate insulin pump. You still need to manually adjust the amount of insulin the pump delivers at mealtimes and when you need a correction dose. You also will need to test your blood with a glucose meter several times a day. Talk with your health care provider about whether this system might be right for you.

The illustration below shows the parts of a type of artificial pancreas system.

An artificial pancreas system uses a continuous glucose monitor, an insulin pump, and a control algorithm to give you the right amount of basal insulin.

The continuous glucose monitor sends information through a software program called a control algorithm. Based on your glucose level, the algorithm tells the insulin pump how much insulin to deliver. The software program could be installed on the pump or another device such as a cell phone or computer.

Starting in late 2016 and early 2017, the NIDDK has funded several important studies on different types of artificial pancreas devices to better help people with type 1 diabetes manage their disease. The devices may also help people with type 2 diabetes and gestational diabetes.

NIDDK is also supporting research into pancreatic islet transplantation—an experimental treatment for hard-to-control type 1 diabetes. Pancreatic islets are clusters of cells in the pancreas that make insulin. Type 1 diabetes attacks these cells. A pancreatic islet transplant replaces destroyed islets with new ones that make and release insulin. This procedure takes islets from the pancreas of an organ donor and transfers them to a person with type 1 diabetes. Because researchers are still studying pancreatic islet transplantation, the procedure is only available to people enrolled in a study. Learn more about islet transplantation studies.

What health problems can people with type 1 diabetes develop?

Over time, high blood glucose leads to problems such as

  • heart disease
  • stroke
  • kidney disease
  • eye problems
  • dental disease
  • nerve damage
  • foot problems
  • depression
  • sleep apnea

If you have type 1 diabetes, you can help prevent or delay the health problems of diabetes by managing your blood glucose, blood pressure, and cholesterol, and following your self-care plan.

Can I lower my chance of developing type 1 diabetes?

At this time, type 1 diabetes can’t be prevented. However, through studies such as TrialNet, researchers are working to identify possible ways to prevent or slow down the disease.

For one thing, symptoms take longer to show up in grownups than they do in kids. This can make it harder for doctors to know what’s going on, especially if they don’t specialize in the condition.

Another confusing part of getting a diagnosis is that many people with type 1 diabetes are lean or have a normal weight. Your doctor might rule out diabetes, since most people with type 2 diabetes are overweight.

Your doctor may suggest several tests that can tell you if you have diabetes, although you won’t know if it’s type 1 or type 2.

Glycated hemoglobin (A1c) test. It measures your average blood glucose level for 2 to 3 months. If you have an A1c level of 6.5 or higher on two separate exams, you have diabetes.

Random blood sugar test. It checks your blood glucose at a random time of day. A level of 200 mg/dL or higher is a sign that you have diabetes.

Fasting blood sugar test. Your doctor does this first thing in the morning, before you’ve eaten. You have diabetes if your level is 126 mg/dL or higher on two separate tests.

Besides those exams, your doctor may also test your blood for certain antibodies that are common in type 1 diabetes.

And he might check your pee for ketones, or fat by-products. If these are in your sample, you probably have type 1 diabetes.

Whether you have type 1 diabetes, are a caregiver or loved one of a person with type 1 diabetes, or just want to learn more, the following page provides an overview of type 1 diabetes.

New to type 1 diabetes? Check out “Starting Point: Type 1 Diabetes Basics,” which answers some of the basic questions about type 1 diabetes: what is type 1 diabetes, what are its symptoms, how is it treated, and many more!

Want to learn a bit more? See our “Helpful Links” page below, which provides links to diaTribe articles focused on type 1 diabetes. These pages provide helpful tips for living with type 1 diabetes, our patient-perspective column by Adam Brown, drug and device overviews, information about diabetes complications, and some extra pages we hope you’ll find useful!

Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me, diaTribe senior editor Adam Brown’s book, has hundreds of tips for better managing diabetes. Get it as a free PDF here or for $6 on Amazon.com.

Starting Point: Type 1 Diabetes Basics

  • What is type 1 diabetes?

  • Can type 1 diabetes be prevented?

  • What is the risk of developing type 1 diabetes if it runs in my family?

  • What are its symptoms?

  • How is it diagnosed?

  • How is it treated?

  • Do all people with type 1 diabetes wear pumps?

  • How many people with type 1 diabetes use continuous glucose monitors?

  • What is hypoglycemia?

  • What is hyperglycemia?

  • What are the complications of type 1 diabetes?

  • Does type 1 diabetes affect life expectancy?

What is Type 1 Diabetes? Type 1 diabetes is a disease in which the body can no longer produce insulin. Insulin is normally needed to convert sugar (also called glucose) and other food sources into energy for the body’s cells. It is believed that in people with type 1 diabetes, the body’s own immune system attacks and kills the beta cells in the pancreas that produce insulin. Without insulin, the body cannot control blood sugar, and people can suffer from dangerously high blood sugar levels (called hyperglycemia). To control their blood glucose levels, people with type 1 diabetes take insulin injections. Before the discovery of insulin, type 1 diabetes was a death sentence (and it still is for patients with poor access to insulin).

Can Type 1 Diabetes Be Prevented? Unfortunately, the genetic and environmental triggers for the immune attack that causes type 1 diabetes are not well understood, although we know that family members of people with type 1 diabetes are at more risk. There is currently no known way to prevent type 1 diabetes, although Diabetes TrialNet runs studies testing various treatments that could potentially prevent or slow progression of the disease.

What is the Risk of Developing Type 1 Diabetes if it Runs in My Family? People who have family members with type 1 diabetes are more likely to develop it themselves. According to the Joslin Diabetes Center, if an immediate relative (parent, brother, sister, son or daughter) has type 1 diabetes, your risk of developing type 1 diabetes is about 10 to 20 times the risk of the general population (normally a 1% risk). If one child in a family has type 1 diabetes, their siblings have about a 1 in 10 risk of developing it by age 50. Interestingly, a child from a father with type 1 diabetes has about a 10% chance of developing it, while a child with a mother with type 1 diabetes has about a 4% risk of developing it if the mother was 25 or younger at birth, and a 1% risk of developing it if the mother was older than 25 at birth (consistent with the general population risk).

What are its Symptoms? According to the American Diabetes Association, the common symptoms of type 1 diabetes are:

  • Urinating often

  • Feeling very thirsty

  • Feeling very hungry even though you are eating

  • Extreme fatigue

  • Blurry vision

  • Cuts/bruises that are slow to heal

  • Weight loss even though you are eating more

How is it Diagnosed?

According to the ADA, diabetes can be diagnosed through any one of the following tests:

  1. A glycated hemoglobin test, which is commonly referred to as an HbA1c, or simply A1c, test. This test measures the body’s average blood sugar levels from the past 3 months. An A1c of 6.5% or higher is considered a diagnosis of diabetes, 5.7% to 6.4% is considered prediabetes, and an A1c of under 5.7% is considered normal.

  2. A fasting plasma glucose (FPG) test, which measures the body’s glucose level after fasting (no caloric intake) for eight hours. An FPG result of 126 mg/dl or greater indicates a positive diagnosis of diabetes.

  3. An oral glucose tolerance test (OGTT), which measures the body’s blood glucose level two hours after the intake of 75-grams of glucose. An OGTT result of 200 mg/dl or greater indicates a positive diagnosis of diabetes.

  4. In someone with classic symptoms of hyperglycemia (high blood sugar), a random plasma glucose test with a result of 200 mg/dl or greater indicates a positive diagnosis of diabetes.

  5. *Note, it is possible to get a diabetes-related antibody test to confirm a diagnosis of type 1 diabetes specifically (and not another kind of diabetes).

How is it Treated? People with type 1 diabetes use insulin daily in order to help control their blood sugar levels. There are two main types of insulin: basal insulin and prandial (meal-time) insulin. Basal insulin is designed to be injected once or twice per day to provide a constant low level of insulin over time. Basal insulin helps keep blood sugars at a consistent level when you are not eating, but it is not enough to cover glucose spikes after mealtime. Prandial insulins, on the other hand, are taken before mealtime and act rapidly on the body, serving to bring down the high sugar levels following meals. Other drugs like Symlin (pramlintide) can help lower appetite and lower post-meal blood sugar levels, and some people with type 1 diabetes take other drugs off-label that may also help control blood sugar. For a full overview of diabetes drugs available today, please see our diabetes drugs resource page.

Do All People with Type 1 Diabetes Wear Pumps? According to data from the T1D Exchange, about 50% of people with type 1 diabetes in the US use insulin pumps. These patients are seen at the best centers, so the overall number on pumps is likely lower. Most patients with type 1 diabetes choose to inject their insulin manually with insulin pens or syringes.

How Many People with Type 1 Diabetes Use Continuous Glucose Monitors? According to data from the T1D Exchange, about 15%-20% of people with type 1 diabetes in the US use continuous glucose monitors (CGMs). Many patients and healthcare providers find CGMs to be incredibly valuable to diabetes management (you can read more in Adam’s account of how CGMs improved his management here). However, some patients have found that CGMs can be expensive and may not be covered under some insurance plans. CGMs are currently not reimbursed through Medicare (although hopefully that changes soon!).

What is Hypoglycemia? A blood sugar level of under 70 mg/dl (3.9 mmol/l) is typically considered hypoglycemia (low blood sugar), and can result in irritability, confusion, and even seizures and unconsciousness for extreme lows. To correct hypoglycemia, patients commonly use fast-acting carbohydrates to bring their blood sugar back to normal. In extreme cases, a glucagon injection pen can be used. According to the Mayo Clinic, symptoms of hypoglycemia are:

  • Early signs and symptoms: shakiness, dizziness, sweating, hunger, irritability or moodiness, anxiety or nervousness, and headache

  • Nighttime symptoms: damp sheets or bed clothes due to perspiration, nightmares, tiredness, and irritability or confusion upon waking

  • Severe symptoms: clumsiness or jerky movements, muscle weakness, difficulty speaking or slurred speech, blurry or double vision, drowsiness, confusion, convulsions or seizures, and unconsciousness

What is Hyperglycemia? A blood glucose level of over 180 mg/dl (10 mmol/l) is considered hyperglycemia (high blood sugar), and can result in nausea, fatigue, and eventually lead to long-term complications. To correct hyperglycemia, patients commonly use a dose of rapid-acting insulin. According to the Mayo Clinic, symptoms of hyperglycemia are:

  • Early signs and symptoms: frequent urination, increased thirst, blurred vision, fatigue, and headache

  • Later signs and symptoms: fruity-smelling breath, nausea and vomiting, shortness of breath, dry mouth, weakness, confusion, coma, and abdominal pain

What are the Complications of Type 1 Diabetes? Type 1 diabetes increases the risk of developing several medical complications. The risk of these complications decreases with better blood sugar control. Diabetes complications include:

  • Heart and blood vessel problems

  • Diabetic ketoacidosis (DKA)

  • Nerve damage (neuropathy)

  • Kidney damage (nephropathy)

  • Eye damage (retinopathy)

  • Foot damage and amputation

  • Pregnancy complications

  • Depression or diabetes distress

Does Having Type 1 Diabetes Affect My Life Expectancy? According to the JDRF, some research shows that in the absence of kidney damage, the life expectancy in people with type 1 diabetes is no different than in the general population. The literature on life expectancy in type 1 diabetes is sparse, but studies show a positive trend, due in part to advancements in therapies and technologies. A recent study published in 2012 found that people with type 1 diabetes diagnosed between 1965-1980 had a life expectancy of 69 – a major improvement compared to those diagnosed between 1950-1964, who had an average life expectancy of 53 years. However, there is still much to be done in ensuring that all patients have access to appropriate healthcare and treatments, and take care of themselves correctly, so their life expectancy becomes similar to the general population.

  • The Basics

  • A Patient Perspective from Adam’s Corner

  • Devices

  • Insulin and Other Drugs

  • Complications

  • Extra Info

The Basics

The diaTribe Patient’s Guide to Individualizing Therapy – Some helpful questions you can ask yourself in preparation for a visit with your health care provider.

Cholesterol 101 – An overview of the different types of cholesterol and how to keep yourself at healthy levels of each

Blood Pressure 101 – An explanation of why this simple health measurement is particularly relevant for people with diabetes.

The diaTribe Advisory Board on What Every Person with Diabetes Must Know – Our star-studded advisory board of diabetes educators, endocrinologists, and more, give their tips on managing diabetes.

Dr. Anne Peter’s Top Ten Actionable Tips – Some helpful tips regarding communicating and improving relationships with your healthcare provider.

Top Ten Tips for People Newly Diagnosed with Type 1 Diabetes – Ten helpful tips to get you started.

Top Ten Things I Wish My Parents Knew When I Was Diagnosed With Diabetes – A short guide to show how diabetes will, and won’t, change your daily life, personality, and family life.

A Patient Perspective from Adam’s Corner

A Home Run Breakfast with Diabetes – Seven things I do to beat the hardest meal of the day.

Mastering Motivation with Diabetes – Master motivation by asking great questions, identifying key barriers, and using proven tactics for diabetes, diet, exercise, and more.

10 Tips for Teenagers to Live Well with Diabetes – Adam shares his top 10 tips for living with type 1 diabetes, straight from presentation to 100+ teens at Friends for Life.

Low Carb vs. High Carb – My Surprising 24-day Diabetes Diet Battle – What I learned from doubling my carb intake: more work, more danger, but the same average blood sugar. Huh?

Get in the Zone: My Tips for Avoiding Hypoglycemia During Exercise – Diagnosing & solving hypoglycemia (lows) & hyperglycemia (highs) during exercise with diabetes. It’s all about personal experimentation.

10 Diet Commandments for Better Diabetes Management – The ten diet commandments Adam follows for healthy eating with diabetes, plus a guide to how to write your own and overcome obstacles.

How Many Factors Actually Affect Your Blood Sugar? – Adam identifies 22 factors that can affect blood sugar on a daily basis

“What Are Your Diabetes Landmines?” The Seven Mistakes I Always Make and What I Learned Trying to Avoid Them – Adam provides solutions to the common issues he and many other patients have when managing their diabetes

Getting to Goal – The Four Biggest Game-Changers for Improving My Diabetes Management – Adam describes the four things that have made the biggest difference in his diabetes management

Devices

Diabetes Devices Resource Page – Our comprehensive overview of the various diabetes devices out there

Making the Most of Meter Data – Gary Scheiner (MS, CDE) provides an overview of how to use blood glucose meters and their data for maximum results

Test Drive – Insulet OmniPod – Adam and Kelly test out this insulin pump, known for its tubing-free design

Test Drive – The Bionic Pancreas – Kelly’s experience in the Bionic Pancreas Beacon Hill study

Test Drive – Medtronic MiniMed 530G and Enlite CGM – Adam tries out this product, which has been called the “first step to an artificial pancreas”

Test Drive – Dexcom Share – Adam and Kelly try out the Dexcom Share remote monitoring system

Insulin and Other Drugs

Diabetes Drugs Resource Page – Our comprehensive overview of the available diabetes drugs, explaining the pros and cons of each

Insulins Unplugged – An overview of the different varieties of insulin available today

Beyond the Basals – Part 1 and Beyond the Basals – Part II – Gary Scheiner (M.S., CDE) provides an overview of insulin pumps and how to use them in this two-part series

Avoiding Complications of Diabetes – Dr. Mark Yarchoan provides an overview of the various complications of diabetes and how to help prevent them.

Talking About Complications – Kerri Sparling (SixUntilMe) discusses the shame and guilt that can come with complications and how a strong support network can make all the difference.

How Much Do You Know about Diabetes and Kidney Disease? – Our overview of what all of us need to know about one of our most vital organs – our kidneys.

Expand Your Knowledge of Diabetic Macular Edema (DME) – An overview of this diabetes complication and the three steps everyone can take to prevent it.

Diabetic Neuropathy: Knowledge is Power – Neuropathy occurs when the nerves are damaged and it can result in pain or numbness, read our prevention and treatment overview here.

Diabetes and Depression: Seven Things to Know and Resources to Help You Take Action – We examine the mental burden of diabetes, including depression and diabetes distress.

A Silent Complication: A Closer Look at Diabetic Retinopathy – Leading ophthalmologist Dr. Ivan Suñer on what diabetic retinopathy is, how to prevent it, and what future treatments hold.

Diabetic Ketoacidosis Explained – What is DKA, and what can patients do to prevent this diabetes complication?

TEST DRIVE: NeuroMetrix Quell – What Did People with Chronic Neuropathy Pain Say About the New Pain Relief Device?

Extra Info

The Diabetes Resource – A useful website for all questions related to diabetes.

The Step-by-Step Approach to Better Blood sugars and a Healthier 2013 – Adam investigates how exercise, primarily walking, can positively affect your health and blood sugar levels.

Ten Tips for Changing Habits, Adopting New Behaviors, and Achieving Your Goals – Some tips on mentality by Adam for people newly diagnosed with diabetes.

The Future of the Type 1 Diabetes Field – An interview by the diaTribe staff with David Panzirer and Dana Ball about the future of research in the Type 1 diabetes field.

*Please note, this page is not a comprehensive list of all of the available resources.

Type 1 diabetes (insulin-dependent diabetes mellitus) is an autoimmune disease in which the pancreas is unable to produce enough of a hormone called insulin. This reduced insulin production results in a higher-than-normal level of glucose in the blood – a condition called ‘hyperglycaemia’ (high blood glucose).

About 120,000 people in Australia have Type 1 diabetes. It’s usually diagnosed during childhood or early adulthood, but it can develop at any age.

Glucose is a type of sugar that comes from carbohydrates in your food and it’s your body’s main source of fuel. Insulin enables glucose in your blood to enter your body’s cells, where it is converted into useable energy.

If your pancreas doesn’t produce enough insulin, then glucose is less able to enter your body’s cells. Your body’s cells are then less able to access the fuel they need for energy, and there will also be a corresponding build-up of glucose in your blood. This will eventually lead to the development of hyperglycaemia (high blood glucose) and it is this hyperglycaemia that causes the characteristic symptoms – and potential complications – of Type 1 diabetes.

Symptoms of Type 1 diabetes

The common symptoms of Type 1 diabetes are due to the higher-than-normal blood glucose levels that are associated with the disease.

Increased urination: When you have too much glucose in your blood, your kidneys have to filter increased sugar which makes them produce larger amounts of urine. Experiencing a need to pass urine more often than usual is therefore one of the common symptoms of Type 1 diabetes.

Unquenchable thirst: Another common symptom of Type 1 diabetes is unquenchable thirst. The thirst is a response to dehydration resulting from the excess urine production and also from water being drawn from the tissues due to high blood sugar levels.

Increased thirst and urination are often the first noticeable symptoms of Type 1 diabetes.

Other commonly reported symptoms of Type 1 diabetes include:

  • tiredness;
  • unexplained weight loss (a sign that the body’s cells are having to use stored fat for energy, because they cannot access glucose in the blood);
  • hunger (often for sweet foods);
  • blurred vision; and
  • slower-than-normal healing of cuts or wounds.

Causes

Type 1 diabetes is an ‘autoimmune’ disease. An autoimmune disease is one in which the body’s immune system, which normally protects the body against anything it recognises as being ‘foreign’, such as bacteria or viruses, mistakenly identifies a healthy part of the body as being foreign and attacks it.

In cases of Type 1 diabetes, the body’s immune system is thought to attack and destroy insulin-producing cells in the pancreas, creating a shortage of insulin.

Risk factors

Scientists are still unsure what causes the body’s immune system to attack insulin-producing cells in the pancreas.

We do know that Type 1 diabetes usually runs in families, which means that the disease may be at least partly due to genetic (inherited) factors.

Most cases of Type 1 diabetes are likely to be the result of both genetic factors and the action of one or more environmental ‘triggers’ (e.g. viral, dietary or chemical). Possible triggers or risk factors (none of which have been proven) include exposure to certain viruses, early exposure to cow’s milk, weight gain during early life and vitamin D deficiency.

Nothing has been proven to help delay or prevent the onset of the disease.

Complications

Having a persistently high blood glucose level can lead to many possible complications.

Diabetic ketoacidosis

For example, if your blood glucose levels remain high, you are at risk of developing a potentially life-threatening condition called ‘diabetic ketoacidosis‘.

Diabetic ketoacidosis occurs when the body’s cells are unable to take up glucose from the blood (due to insufficient insulin production in the pancreas) and – instead – start breaking down fat, to use as energy. Unfortunately, this breakdown of fat results in the production of toxic acids called ketones. And these ketones can build up in the blood.

The presence of large amounts of ketones in the blood is called ketoacidosis and it’s a condition that can lead to a coma, and even death, if left untreated. It’s therefore important to be able to recognise the possible symptoms of diabetic ketoacidosis (e.g. nausea; vomiting; abdominal pain; deep rapid breathing or breathlessness; extreme drowsiness; sweet or ‘fruity’-smelling breath, especially in the setting of rapid weight loss and newly diagnosed type 1 diabetes) and to know what to do if you suspect that you might be developing the condition.

Having a persistently high blood glucose level can also lead to a number of potential longer-term complications that tend to develop gradually, over many years or even decades. These include the development of damage to blood vessels, increasing the risk of:

  • Heart and blood vessel disease (increasing the risk of heart attack and stroke);
  • Peripheral vascular disease (e.g. damage to small blood vessels in the feet, which can reduce blood supply to the feet, causing delayed healing from blisters or sores and, in very serious cases, lead to a need for surgery or amputation);
  • Kidney damage (nephropathy; in severe cases, this nephropathy may lead to kidney failure, requiring dialysis or a kidney transplant);
  • Eye damage (e.g. retinopathy, which is damage to the retina at the back of the eye and can lead to blindness if left untreated; people with Type 1 diabetes are also at increased risk of developing cataracts or glaucoma); and
  • Nerve damage (neuropathy), which may lead to tingling, numbness, burning sensations or pain in the hands, feet or legs, as well as erectile problems in men.

Be aware that having a high blood glucose level can weaken the body’s immune system, increasing the risk of infection.

People with diabetes may be more susceptible to developing skin and mouth problems, including bacterial and fungal infections, such as thrush or recurrent boils.

Diagnosis

To make a diagnosis of Type 1 diabetes, your doctor will need to consider multiple factors, including your symptoms, age, family history of diabetes, body weight and current medications. However, a diagnosis can only be confirmed after a blood test has revealed the presence of a raised blood glucose level. In Australia, this diagnostic blood test may be either:

  • A fasting blood glucose test (FBGT), where the blood sample to be tested is taken no less than about eight hours eating; or
  • A ‘random’ blood glucose test (RBGT), where the blood sample to be tested is taken at any time.

You are likely to have diabetes if your:

  • FBGT shows that your blood glucose level is 7.0 millimoles (mmol) per litre (L) or higher; or
  • RBGT shows that your blood glucose level is 11.1 mmol/L or higher.

If a blood glucose test result is borderline or inconclusive, then an oral glucose tolerance test (OGTT) may be needed to confirm a diagnosis of diabetes; this involves the testing of 2 or more blood samples, taken before and after drinking a prepared glucose drink.

Other possible tests that might be performed in cases of Type 1 diabetes include:

  • Islet cell autoantibody test – a blood test to check for the presence of antibodies targeted against islet cells, the insulin-producing cells in the pancreas.
  • Blood or urine test for ketones – to check the level of ketones in the body.
  • Glycated haemoglobin (HbA1C) test – a blood test that shows what your average blood glucose level has been over the past 2–3 months (in Australia, HbA1c testing is not used to diagnose Type 1 diabetes; but it is used to help monitor the effectiveness of diabetes treatment).

Treatment

Type 1 diabetes is a life-long disease, for which there is currently no cure.

The overall aim of treatment in cases of Type 1 diabetes is to maintain a normal, healthy level of glucose in the blood. Doing this will not only help to prevent or relieve the symptoms of diabetes, but will also help to prevent, delay or minimise potential complications of the disease.

Blood glucose monitoring

People with Type 1 diabetes need to regularly monitor their blood glucose level every day, at a variety of different times (e.g. fasting, before meals, 2 hours after meals), as well as be mindful of things that are likely to affect this level (e.g. the type and amount of foods they eat, the length of time they leave between meals, the amount of exercise they do) and how each of these things is likely to affect it.

Insulin injections

Importantly, people with Type 1 diabetes also need to inject insulin several times each day (or receive insulin via an insulin pump) – to replace the insulin that their pancreas is not producing. Insulin allows your body’s cells to take up glucose from the blood and thereby reduces the amount of glucose in your blood.

The ideal level of blood glucose will vary from person-to-person. If you have been diagnosed with Type 1 diabetes, your doctor and/or Credentialled Diabetes Educator will help you determine what target you need to aim for. He or she will also explain:

  • When you need to check your blood glucose level and how to do this (usually by ‘finger prick’ testing, using a portable glucose meter);
  • When you need to inject your insulin and how to do this (including how to calculate the correct dose); and
  • What else you can do to help manage your blood glucose level and keep it within the recommended target range.

In Australia, there are a number of different types of insulin available via the Pharmaceutical Benefits Scheme (PBS), which differ in how quickly they work and how long they last in the body; these include:

Once again, if you have been diagnosed with Type 1 diabetes, your doctor and/or Credentialled Diabetes Educator will help you determine what type of insulin is likely to best meet your specific needs.

The good news is that injecting insulin tends to be easier than most people think it will be. The most common way to inject insulin is by using a fine needle and syringe or by using a ‘pen’ injector device (a ‘pen needle’). In Australia the needles are free for people who are registered with the National Diabetes Services Scheme (NDSS).

Insulin pump

In some cases, insulin may be administered using an insulin pump, a small device that is worn outside the body (e.g. on a belt) and programmed to deliver small, regular doses of insulin via a flexible tube that is inserted under the skin. This type of insulin administration is sometimes called continuous subcutaneous insulin infusion (CSII).

Lifestyle and self-help

In addition to monitoring and managing their blood glucose level, and using their prescribed insulin therapy as directed, people with Type 1 diabetes are advised to maintain a healthy, balanced diet and also to try to remain as physically active as possible. Doing these things will help to maintain a healthy weight (a possible side effect of insulin therapy is weight gain), may help to improve blood glucose control and might also help to prevent or minimise some of the longer-term complications of diabetes (e.g. heart disease).

People who have Type 1 diabetes need to know how to manage several situations:

  • Hyperglycaemia. Know what to do if their blood glucose level becomes too high and they begin to develop symptoms of possible ketoacidosis. If you have Type 1 diabetes, many possible things can cause your blood glucose level to rise unexpectedly; for example, it may rise if you eat too much, if you eat the wrong types of food, if you don’t inject enough insulin or if you have an illness.;
  • Ketoacidosis. Test for ketones (either in their urine or in their blood ), particularly during acute illness or stress, if their blood glucose level is consistently higher than 15 mmol/L or if they have any symptoms of ketoacidosis (such as feeling sick, vomiting or abdominal pain). People with type 1 diabetes should also know when to call their doctor immediately or when to go to the nearest emergency department.
  • Hypoglycaemia. People with Type 1 diabetes also need to know what to do if they develop ‘hypoglycaemia’ (too low blood sugar). Hypoglycaemia is what happens when the level of glucose in a person’s blood falls too low, commonly referred to as having ‘a hypo’. Blood glucose levels can fall too low for many reasons; for example, they may fall too low if you skip or delay a meal (or don’t eat enough), do more physical activity than usual or inject a larger dose of insulin than usual. Symptoms of hypoglycaemia can include weakness, trembling or shaking, sweating, light-headedness, headache, inability to concentrate, behaviour change, dizziness, tearfulness/crying, irritability, numbness around the lips/fingers and/or hunger.

Of course, people with Type 1 diabetes should always contact their doctor or Credentialled Diabetes Educator (or another healthcare professional involved in the management of their diabetes) if they ever have any specific concerns about their diabetes, its management or any related issues (e.g. if they have trouble managing their blood glucose level or if they are unsure what they should do in a particular situation).

In addition, people with diabetes are encouraged to inform people around them about their condition, to wear an appropriate medical alert bracelet and to carry a kit that contains everything they might need if they experience hypoglycaemia.

Prevention

Type 1 diabetes cannot be prevented, but – if you have the disease – there are many things you can do to help prevent, delay or minimise its potential complications; this includes:

  • Doing all the things you have been advised to do to help keep the level of glucose in your blood within the recommended target range;
  • Taking prescribed medications as directed (including medications to help manage diabetes-related health problems or to help reduce the risk of specific diabetes-related complications, such as blood pressure-lowering medication or cholesterol-lowering medication);
  • Knowing what to do if you develop symptoms of possible ketoacidosis or hypoglycaemia;
  • Trying to keep your blood pressure and blood cholesterol levels within recommended target ranges;
  • Not smoking (smoking increases the risk of several long-term diabetes-related complications, such as heart disease and stroke);
  • Being as physically active as possible (e.g. walking briskly for at least 30 minutes, 5 times a week);
  • Following a healthy eating plan;
  • Limiting your alcohol intake (no more than 2 standard drinks per day);
  • Maintain a healthy body weight;
  • Checking your feet each day and choosing footwear that protects them;
  • Remembering to visit your GP for all recommended check-ups (e.g. 6-monthly HBA1c, annual lipids (cholesterol) test), etc; and
  • Remembering to get your eyes and feet regularly checked.

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Last Reviewed: 09/08/2018

Type 1 Diabetes – Symptoms

Diabetes Symptoms

The following symptoms of diabetes are typical. However, some people with diabetes have symptoms so mild that they go unnoticed.

Common symptoms of diabetes:

  • Urinating often
  • Feeling very thirsty
  • Feeling very hungry—even though you are eating
  • Extreme fatigue
  • Blurry vision
  • Cuts/bruises that are slow to heal
  • Weight loss—even though you are eating more (type 1)
  • Tingling, pain, or numbness in the hands/feet (type 2)

Early detection and treatment of diabetes can decrease the risk of developing the complications of diabetes.

Although there are many similarities between type 1 and type 2 diabetes, the cause of each is very different. And the treatment is usually quite different, too. Some people, especially adults who are newly diagnosed with type 1 diabetes, may have symptoms similar to type 2 diabetes and this overlap between types can be confusing. Take our Risk Test to find out if you are at increased risk for having type 2 diabetes.

Symptoms of type 1 diabetes onset in an infant or child

The young child who is urinating frequently, drinking large quantities, losing weight, and becoming more and more tired and ill is the classic picture of a child with new-onset type 1 diabetes. If a child who is potty-trained and dry at night starts having accidents and wetting the bed again, diabetes might be the culprit.

Although it is easy to make the diagnosis diabetes in a child by checking blood sugar at the doctor’s office or emergency room, the tricky part is recognizing the symptoms and knowing to take the child to get checked. Raising the awareness that young children, including infants, can get type 1 diabetes can help parents know when to check for type 1 diabetes.

Sometimes children can be in diabetic ketoacidosis (DKA) when they are diagnosed with diabetes. When there is a lack of insulin in the body, the body can build up high levels of an acid called ketones. DKA is a medical emergency that usually requires hospitalization and immediate care with insulin and IV fluids. After diagnosis and early in treatment, some children may go through a phase where they seem to be making enough insulin again. This is commonly called the “honeymoon phase”. It may seem like diabetes has been cured, but over time they will require appropriate doses of insulin to keep their blood sugar levels in the normal range.

Symptoms of type 1 diabetes onset in adults

When an adult is diagnosed with diabetes, they are often mistakenly told that they have type 2 diabetes. This is because there is still a lack of an understanding in the medical community that type 1 diabetes can start at any age. It can also be tricky because some adults with new-onset type 1 diabetes are often not sick at first. Their doctor finds an elevated blood sugar level at a routine visit and starts them on diet, exercise and an oral medication. On the other hand, there are people who look like they have type 2 diabetes—they may be Latino or African American and/or overweight, but they have type 1 diabetes after all. This can be difficult for even the brightest doctor to diagnose.

Maybe it’s a different type

If you or someone you know is diagnosed with type 2 diabetes but isn’t responding well to the typical treatments for type 2 diabetes, it may be worth a visit to an endocrinologist to determine what type of diabetes is happening. Generally, this requires antibody tests and possibly the measurement of a C-peptide level.

Women with gestational diabetes often have no symptoms, which is why it’s important for at-risk women to be tested at the proper time during pregnancy.
Learn more

Symptoms of diabetes complications

Have you already been diagnosed with diabetes but are concerned about symptoms that may be the result of complications related to diabetes?
Find out more

Learn more

Do you have questions or concerns about diabetes symptoms? Want to connect with others? Join the American Diabetes Association Community to find support.

If you’ve recently been diagnosed with type 2 diabetes, enroll in the free Living With Type 2 Diabetes Program to get more information and support.

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